Relationship between bone structure parameters in lower lumbar spine and lumbar disc herniation

doi:10.3969/j.issn.2095-4344.2014.35.020

Abstract

Abstract:

BACKGROUND: Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative still deserves further exploration.
OBJECTIVE: To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc.
METHODS: From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle.
RESULTS AND CONCLUSION: Process deflection angle at L4 and L5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z = -10.609, -12.074, P < 0.01). There was not significant statistical difference between the lower lumbar disc herniation group and the control group on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle at various ages (P > 0.05). There only was significant difference on lumbosacral angle between male group and female group (P= 0.007 < 0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P < 0.01), and there was significant difference between 45-54 age group and 25-34 age group (P < 0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: lumbar vertebrae, intervertebral disk displacement, dissection

CLC Number:

R318

Lin Zhi-jun, Li Yu-mao, Xie Xiao-yong, Li Ping-sheng, Li Tian-ran, Liu Ai-hua, Liu Hang-tao. Relationship between bone structure parameters in lower lumbar spine and lumbar disc herniation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(35): 5687-5692.

Figures/Tables 1

2.1 参与者数量分析按意向性处理，纳入350例患者，其中腰椎间盘突出症患者207例，非腰椎间盘突出者143例。全部进入结果分析，无脱落。 2.2 基线资料比较腰椎间盘突出者207例，男112例，女95例；其中L4/5间盘突出97例，占45.419%；L5/S1间盘突出43例，占20.77%；L4/5、L5/S1均突出者67例，占32.36%；测量207例患者414个椎体关节突关节角差，其中对称246个，非对称168个。对照组143例，男70例，女73例；测量143例患者286个椎体关节突关节角差，其中对称201个，非对称85个。所有计量资料数值均符合正态分布，各组数值方差齐。腰椎间盘突出症组与对照组在性别、年龄上差异无显著性意义，经t 检验和χ2检验，P > 0.05，具有可比性，见表1。 2.3 棘突偏斜角的比较腰椎间盘突出症组与对照组棘突偏斜角在L4、L5水平均存在差异，数据不呈正态分布，应用秩和检验，见表2。 2.4 关节突的非对称性、腰椎曲度角、腰骶关节角各年龄段的比较见表3。由表3结果可知，腰椎间盘突出症组与对照组在关节突关节的非对称性、腰椎曲度、腰椎曲度角、腰骶关节角各个年龄段间比较差异无显著性意义(P > 0.05)。 2.5 不同年龄组间下腰椎间盘突出症患者的骨性结构参数比较见表4。由表4结果可知，55-65岁组的关节突关节的非对称性、腰椎曲度角及腰骶关节角与25-34及35-44组相比差异均有显著性意义(P < 0.01)；在45-54岁组和25-34岁组之间各个参数的比较差异也有显著性意义(P=0.005 6 < 0.01)。相邻年龄段组之间各参数比较差异无显著性意义 (P > 0.05)。 2.6 腰椎间盘突出组男性、女性各测量指标比较见表5。由表5可知，腰椎间盘突出患者中腰椎曲度的改变在男、女性别中差异无显著性意义(P > 0.05)，均有变小的趋势。女性的腰骶关节角减小趋势较男性明显，数据统计有明显差异性(P < 0.05)。结果表明女性腰椎间盘突出患者中腰骶关节角明显变小。"

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